Effectively managing healthcare benefits is crucial for organizations aiming to offer comprehensive, high-quality support to their employees. Performance metrics are essential for evaluating and benchmarking the success of these benefits, allowing organizations to make informed decisions and improve their healthcare strategies. These metrics provide insight into workforce health, the efficiency of the health benefits program, and the financial impact on the organization.

Key healthcare benefits measures.

1. Total healthcare spend.

+ This metric is crucial for budgeting and financial planning, as it reflects the direct cost burden of providing health benefits. Budgeting should account for your organization's growth and rising cost trends. Analyzing healthcare spending can help organizations identify cost drivers, such as high rates of emergency room visits or expensive prescription medications, and develop strategies to manage these expenses more effectively.

2. Employee engagement.

+ Employee engagement measures the level of employee participation in the organization's health programs. Higher engagement levels often lead to better health outcomes and lower overall costs. When employees actively participate in wellness initiatives like fitness challenges or smoking cessation programs, they are more likely to adopt healthier behaviors, which can reduce the prevalence of chronic diseases and decrease healthcare costs. Engaged employees are also more likely to utilize preventive services, avoiding more severe health issues down the line.

3. Employee satisfaction.

+ Satisfaction with health benefits is a critical metric that influences overall health and productivity. Satisfied employees are more likely to utilize their health benefits effectively, contributing to overall health and productivity. For instance, if employees are happy with their mental health support options, they are more likely to seek help early, leading to better mental health outcomes and reduced absenteeism. High satisfaction levels can also enhance employee retention and attract top talent, making it a vital metric for competitive advantage.

4. Return on Investment (ROI).

+ ROI measures the financial return on healthcare investments. Ensuring that the organization’s healthcare benefits deliver value for the money spent is crucial. For instance, investing in a robust care navigation platform that helps employees find cost-effective healthcare solutions and avoid unnecessary procedures can significantly improve ROI.

5. Preventive care compliance.

+ Measuring whether employees are adhering to recommended preventive care guidelines is crucial to the health of your team and your bottom line. Ensuring high compliance with preventive screenings like mammograms and colonoscopies can lead to early detection of diseases, which are often less expensive to treat and have better prognoses than conditions caught at later stages. This metric helps identify gaps in care and develop strategies to encourage more consistent use of preventive services.

6. Point solution utilization

+ It takes ample time and money to identify and implement high-quality healthcare point solutions, like telehealth services and mental health support, for your team. High utilization rates of these point solutions indicate that employees are taking advantage of specialized resources tailored to their needs which can lower healthcare costs and improve outcomes. However, if point solutions are not being utilized, it is crucial to identify why and whether or not they are worth the investment.

Challenges in achieving high-performing healthcare benefits offering.

Despite the importance of these metrics, many organizations struggle to optimize their health plan performance. Common challenges include:

• Data silos: Fragmented data across different systems can prevent a comprehensive analysis.

• Ineffective benefits communication: Poor communication channels can result in employees being unaware of or not fully understanding their health benefits, leading to underutilization.

• Low employee engagement: Low engagement in health programs can lead to poor health outcomes and higher costs.

• Complexity of care coordination: Managing care across multiple providers and services can be challenging and inefficient for your teams.

Care navigation is the key to elevating benefits performance.

Care navigation services are designed to address these challenges and help organizations maximize their health plan performance metrics. Here’s how:

Directs members to high-value care.

Care navigation services help employees find the best care options at the most affordable prices. By offering personalized guidance, Rightway ensures that employees avoid unnecessary and expensive treatments and instead receive high-value care. They also identify high-quality, in-network providers and recognize when members are behind on preventive care or need to visit a primary care provider. This approach lowers costs and improves outcomes. 

Creates a better healthcare experience.

Healthcare navigation solutions provide a seamless and supportive healthcare experience for your teams. When members have healthcare needs, they have access to a health guide who can direct them to high-value care, like preventive care and other wellness programs, or answer their questions. The comprehensive support through a care navigation platform boosts satisfaction by taking the work off each member’s place during their time of need.

Provides tailored support for you and your teams.

Health navigation services optimize the use of healthcare resources unique to your organization such as telehealth, mental health support, and other point solutions. Healthcare navigators guide employees toward these services and follow up to ensure they receive the necessary care. This proactive approach ensures that these resources are used effectively, leading to better health outcomes and cost savings. 

Rightway collaborates with benefits leaders to identify top healthcare-related metrics, KPIs, and goals for their population. Whenever a member has a healthcare question or need, they connect with their dedicated health guide through the Rightway app. Health guides provide care decision support, benefits education, steerage to high-quality providers, and billing advocacy based on the strategy outlined to drive your team’s benefits goals. 

Rightway supports members at every step of their healthcare journey. Learn more about how Rightway's care navigation services engage your team, help you achieve your benefit objectives, and save you time so you can focus on your key goals here.